This story gives readers a balanced view of the benefits and harms of screening mammography among women in their 40s based on the results of study comparing the areas in Sweden that offered routine screening to those that did not. It tells readers not only the percentage difference in death rates but also the number that need to be screened to prevent one breast cancer death and statistics on the overall breast cancer death rates among women in this age group.
The clear description of some of the limitations of mammography helps readers see some of the complexity of decisions about screening.
Although the story notes the number of women who would need to be screened to prevent a breast cancer death and the risk of overtreatment, it does not discuss the costs of annual mammography screening, or even provide a range of costs. The story does not discuss any health care policy cost repercussions of breast cancer screening recommendations. The story does not discuss the cost of unnecessary biopsies or other treatments for women who have a false positive diagnosis via mammography (greater in women 40-49).
This story reports the percentage difference in death rates in the lead sentence, but then it also includes several comments and statistics that help readers put that first number in perspective. It includes the number of women in their 40s (1,252) who would need to be screened for a decade in order to prevent one breast cancer death, according to the results of this study. It also includes a quote applying that figure to the United States, suggesting that screening 22 million women could prevent about 2,000 deaths. This story also pointed out that the study did NOT report the true breast cancer mortality rate – in other words, the number of women who died of breast cancer versus the number who were diagnosed with breast cancer.
This story gives readers some details about the potential harms of screening, including “unnecessary stress, unwarranted biopsies and overtreatment.”
The story outlines the key features of the study, noting both strengths (it included over a million women and looked at real world experience) and limitations (lack of information about harms related to screening or differences between the women in the study groups). As noted in our reviews of other stories (and as will be addressed in a separate blog post on Monday October 4), there are many other methodological questions that could have and perhaps should have been raised. But this story nonetheless met the criterion for a satisfactory score.
A strong point of this story is that it tells readers the number of women in the US who die of breast cancer before age 50, so that readers can see it makes up a part (12%) of the total breast cancer death toll.
The story includes comments from more than one independent expert. It does not refer to any potential conflicts of interest, but the researchers did not report any in their journal article.
Although there is not a detailed discussions of alternatives, this story does highlight the fact that “an influential panel of U.S. science advisers” and others say women in their 40s should make individual decisions about screening mammography.
The story doesn’t explicitly address the availability of mammography but we can’t criticize it for that. We can only give it a score of Not Applicable for this criterion.
The story includes some information about what is new or different about how this study looked at the question of the effectiveness of mammography among women in the 40s.
It’s clear that this story did not rely on a news release.